Planning percutaneous coronary interventions using computed tomography angiography and fractional flow reserve-derived from computed tomography: A state-of-the-art review

Catheter Cardiovasc Interv. 2019 Feb 1;93(2):298-304. doi: 10.1002/ccd.27817. Epub 2018 Oct 4.

Abstract

Fractional flow reserve derived by coronary computed tomography angiography (CTA; FFRCT) is an accurate noninvasive method for identifying coronary artery disease (CAD) and detecting hemodynamically significant stenosis. Although initially proposed as noninvasive tools to "rule out" significant CAD in low-risk patients, CTA and FFRCT are now utilized in higher-risk patients. Furthermore, new applications of CTA and FFRCT include a planning tool for percutaneous coronary intervention (PCI), which allows the cardiologist to assess lesion-specific ischemia, plan stent locations and sizes, and use virtual remodeling of the lumen (virtual stenting) to assess the functional impact of PCI. The purpose of this review is to discuss the principles of CTA and FFRCT acquisition, and their application for PCI planning, even before invasive angiography is performed.

Keywords: computed tomography angiography; coronary artery disease; fractional flow reserve; percutaneous coronary intervention.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Clinical Decision-Making
  • Computed Tomography Angiography*
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / therapy
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / physiopathology
  • Coronary Stenosis / therapy*
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / physiopathology
  • Fractional Flow Reserve, Myocardial*
  • Hemodynamics*
  • Humans
  • Percutaneous Coronary Intervention
  • Predictive Value of Tests
  • Severity of Illness Index